Managing Your Workforce in the Omicron Spread and Shortened Recommendations

Key Points:

• In today’s Recommendations for Industry, we discuss CDC’s COVID updates in which it recommends shortening isolation from 10 days for people with COVID-19 to five days, if asymptomatic, followed by five days of wearing a mask when around others. CDC also now recommends five days quarantine followed by strict mask use for an additional five days for those unvaccinated/unboosted; 10 days masking for those who are boosted; testing at day 5 after exposure for all; and immediate quarantine upon symptom occurrence until a negative test result. Read more below.
• On Tuesday, the Biden administration announced new actions to fight Omicron, including purchasing 500 million at-home tests to be distributed for free beginning next month. Americans will be able to order at-home tests from a government website to be delivered to their house for free. The plan also calls for the Defense Production Act to produce as many at-home tests as possible and for the establishment of federal testing sites, beginning in New York City this week.
• Omicron cases rose by 51% in the past week in the U.S. leading to work disruptions, flight cancellations, and overrun testing capacity. The 7-day average of new daily cases is 203,511. (CIDRAP)
• New daily record highs are being recorded globally for COVID-19, mainly due to Omicron, including France, Italy, Australia, and China. The UK reported more than 98,000 COVID-19 cases, confirming 45,307 more Omicron cases, raising its total to 159,932. So far, 407 people have been hospitalized with Omicron infections, and 39 have died. (CIDRAP)
• FDA issued an EUA for Merck’s COVID-19 antiviral molnupiravir, making it the second oral antiviral treatment available for COVID-19. It is authorized for the treatment of mild-to-moderate COVID-19 for patients 18 and over, as it may affect bone and cartilage growth of those younger.
• An early 3-day course of remdesivir lowered the risk for hospitalization or death among non-hospitalized patients at high risk for severe COVID-19 by 87%, according to a study published in The New England Journal of Medicine. The treatment guidelines for COVID-19 from the Infectious Diseases Society of America suggesting remdesivir for certain hospitalized patients contradicts that from WHO, which does not recommend it for any patients hospitalized with COVID-19, regardless of how sick they are.

Influenza:

• According to CDC, influenza activity is increasing, with the eastern and central parts of the country seeing the largest increases and the western part of the country reporting lower levels of influenza virus circulation. The majority has occurred in those aged 5-24; but the proportion of adults aged 25 years and older has been increasing. The percentage of outpatient visits due to respiratory illness is trending upwards and is above the national baseline, and hospitalizations are starting to increase; and the first two influenza-associated pediatric deaths this season were reported this week. 

Recommendations for Industry

Managing Your Workforce in the Omicron Spread and Shortened Recommendations

The big news over the holiday break was two-fold: the continuing spread of Omicron, causing single-day highs around the globe, and the CDC’s updated recommendations for COVID-positive isolation and close contact quarantining.

In the U.S. Omicron cases rose by 51% in the past week with a 7-day average of new daily cases of 203,511. If the U.S. continues to follow the trends of the UK, as we have throughout the pandemic, we can expect this to continue to rise, as the UK is seeing a 2.5-day doubling time of cases.

Even with (or because of) the increased rates, however, CDC has shortened its recommendations for isolation and quarantine based on the science that has shown that most COVID transmission occurs in the 1-2 days prior to symptom onset and the 2-3 days after.

In the update, CDC recommends that those who test positive for COVID-19 isolate for 5 days (down from the previous 10 days).  At day 5, if they no longer have symptoms or “symptoms are resolving,” they can leave isolation and should mask for five days around others. For close contacts, CDC differentiates between the unvaccinated/unboosted – recommending a 5-day quarantine followed by 5-day masking (or 10-day masking if quarantine is not feasible)—and those who have received boosters – recommending 10-day masking with no quarantine. CDC further recommends that all who are exposed as close contacts be tested at day 5 after exposure. And anyone with symptoms, quarantine until a negative test results.

What does this all mean for your business?

TAG’s take is that these shortened periods can help businesses maintain workers and make wellness checks and symptom monitoring all the more important to help minimize spread. So key recommendations following this change in CDC guidance are:

• If a worker has symptoms, even if it is unknown whether it is COVID-19, flu, or other respiratory illness, they should be sent home and be tested. If the test is positive, then the 5-day isolation kicks in.  Symptom monitoring is your best first-line defense. 
• If a worker was exposed but is asymptomatic, they should mask for the recommended 10 days and keep an eye out for symptoms. If they become symptomatic or test positive, then they should isolate.
• If testing is available, prioritize quarantining and testing at day 5 for unvaccinated workers as they’re the most likely to be infectious prior to symptom onset. 

TAG sees the overall goal being minimizing spread while seeking to reduce the impact on your business. Maintaining COVID preventions, with an emphasis on ensuring that those who are symptomatic stay out, will go a long way in our continued fight against COVID.

In case you missed it

• In Thursday’s Recommendations for Industry, we discussed the continuing saga of the Delta and Omicron variants – and where we stand now. Read more here.
• WHO warns world cannot ‘boost its way out’ of pandemic
  • Blanket booster programs in rich countries risk prolonging the battle with COVID-19, WHO chief says, warning that the rush in wealthy countries to roll out additional COVID vaccine doses was deepening the inequity in access to jabs that is prolonging the pandemic. “No country can boost its way out of the pandemic,” he said.
  • However, Israel plans to become first nation to offer fourth coronavirus vaccine dose, offering it to citizens 60 and older and other at-risk groups.
• Covid Omicron: European nations reinstate restrictions

• European leaders are reinstating coronavirus restrictions as the Omicron variant continues to spread across the continent.
  • Germany and Portugal have announced post-Christmas curbs and greater social distancing measures; The Netherlands has gone into lockdown; France, Cyprus and Austria are tightening travel restrictions; and Denmark has closed many indoor spaces. (CNBC)
• Omicron Severity
  • A December 22 report from Imperial College London found evidence of a reduction in the risk of hospitalization for Omicron relative to Delta infections, averaging 20-25% for hospital visits, and 40-45% for those admitted or hospitalized for at least one day.
  • While there is a larger risk of infection with Omicron, due to the reduction in protection provided by both vaccination and natural infection, the report stated that a previous infection reduces the risk of hospital visit by approximately 50% and of a hospital stay of 1+ days by 61%.
  • These findings are in contrast to a December 16 report from the Imperial College that found “no evidence (for both risk of hospitalization attendance and symptom status) of Omicron having different severity from Delta.”
• Omicron Symptoms
  • Data released last week from South Africa’s largest private health insurer suggest that symptoms include a scratchy or sore throat, nasal congestion, a dry cough and muscle pain, especially low back pain.
  • Other reports are showing only subtle differences between Omicron and previous strains, with one possible difference being that Omicron is less likely to cause a loss of taste and smell.
    • Original strain:  48 and 41 percent respectively reporting loss of smell and taste
    • Omicron:  An analysis of a small Omicron outbreak in the Netherlands found only 23 (smell) and 12 (taste) percent loss in vaccinated persons. It’s unclear, though, whether the differences are because of Omicron or some other factor, like vaccination status.
  • Many symptoms vary depending on vaccine status. One report shows that vaccinated patients with Delta or the original coronavirus tend to present with headache, congestion, sinus pressure and sinus pain, while unvaccinated patients are more likely to have shortness of breath and cough, along with flulike symptoms.
• Case drop may show South Africa’s omicron peak has passed –
  • South Africa’s noticeable drop in new COVID-19 cases in recent days may signal that the country’s Omicron-driven surge has passed its peak.
  • After hitting a high of nearly 27,000 new cases nationwide on Thursday, the numbers dropped to about 15,424 on Tuesday. In Gauteng province of South Africa, the decrease started earlier and has continued.
• FDA authorizes first pill to treat COVID-19
  • FDA authorized Pfizer’s antiviral pill, Paxlovid, to treat COVID-19 in high-risk individuals age 12 and older who weigh at least 88 pounds and have a positive SARS-CoV-2 test.
  • Pfizer’s updated results showed the treatment cut the risk of hospitalization or death by 88% if given within the first five days of symptoms, the efficacy was similar.
  • Paxlovid combines a new antiviral drug named nirmatrelvir and an older one called ritonavir and is administered as three pills given twice a day for five days.